U.S. and U.K. gay men differ in definitions of having 'had sex'

BLOOMINGTON, Ind. -- A recent study published by researchers at Indiana University's Kinsey Institute for Research in Sex, Gender and Reproduction found that gay men in the United States and the United Kingdom had different ideas on what constitutes having "had sex."

Brandon Hill

The study has important implications both in research and clinical settings.

"It is important for researchers and clinicians not to assume that their definition of 'sex' is shared by their participant or patient, and to use behaviorally specific criteria when conducting sex-behavior assessments, especially when assessing risk of HIV/AIDS and other sexually transmitted infection transmission," said lead author Brandon Hill, a researcher at the Kinsey Institute.

The study, published in July in the journal AIDS Care, compared a sample of 180 self-identified gay men in the U.K. ranging in age from 18 to 56 with a sample of 190 self-identified gay men in the U.S. ranging from 18 to 74. Both groups were asked to indicate whether they considered various behaviors as having "had sex."

Almost all (95 percent) participants believed that penile-anal intercourse constituted having "had sex." However, U.S. and U.K. gay men differed on the following behaviors:

Giving oral-genital stimulation: 84.9 percent of U.K. gay men believed that this behavior constituted having "had sex," while only 71.6 percent of U.S. gay men defined this behavior as such.

Giving and receiving manual-anal stimulation: 70.9 percent of U.K. gay men believed that this behavior constituted having "had sex," while only 53.4 percent of U.S. gay men defined this behavior as such.

Giving and receiving oral-anal stimulation: 78.4 percent of U.K. gay men believed that this behavior constituted having "had sex," while only 61.2 percent of U.S. gay men defined this behavior as such.

Giving and receiving sex-toy stimulation: 77.1 percent of U.K. gay men believed that this behavior constituted having "had sex," while only 55 percent of U.S. gay men defined this behavior as such.

Significantly more gay men in the United Kingdom considered oral-genital stimulation, manual-anal stimulation, oral-anal stimulation, and use of sex toys as having "had sex." In addition, compared with previously published studies of predominantly heterosexual groups, proportionally more gay men include manual, oral, anal and sex-toy behaviors in their definitions of having "had sex."

This study has many important implications both in research and clinical settings. First, because an individual's definition of "sex" influences the number of reported "sexual partners" and frequency of "sexual activity," it is important for researchers and clinicians to be as behaviorally specific as possible when posing questions to their participants and patients during STI and HIV/AIDS risk assessments. Second, participants and patients might construct their definitions of having "had sex" or their number of "sexual partners" based on the perceived stigma of being labeled "at risk," "sexually compulsive" or "promiscuous." Conversely, participants and patients also may construct their definitions of "sex" based on the benefit of receiving the most accurate risk assessment and treatment.

Coauthors are Q. Rahman, School of Biological and Chemical Sciences, Queen Mary University of London, London; David Bright, School of Psychology, University of East London, London; and Stephanie Sanders, The Kinsey Institute and Department of Gender Studies at Indiana University.